STARS interventions for violence reduction: Safety, technology, activity, relief, and surroundings

Nurs Forum. 2021 Apr;56(2):453-459. doi: 10.1111/nuf.12538. Epub 2020 Dec 16.


Background: Caregivers without behavioral health expertise struggle to manage behaviorally challenging patients while providing continuous observation (CO) care.

Problem: A gap in knowledge exists concerning effective CO interventions to reduce patient violence with limited psychiatric resources. The objectives of this project were to improve safety and engagement among staff providing in-person 1:1 CO for patients and optimize acute care CO utilization.

Methods or interventions: Nurse leaders rounded regularly on CO staff and patients requiring CO and provided the safety, technology, activity, relief, and surroundings interventions tool kit for CO staff, patients, and families. Patient readiness to trial remote video monitoring CO was assessed, and violence prevention and assault reporting education to CO staff was reinforced.

Results: A survey of 46 CO staff demonstrated positive responses to perceptions of: (1) improved safety (p < .01); (2) violence reduction (p < .001); (3) increased awareness of the importance of the CO role (p < .001); and (4) improved CO care (p < .001).

Conclusion: Nurse leader rounding with an educational tool kit yielded CO staff-endorsed feelings of increased staff safety and engagement.

Keywords: innovations; medical-surgical; psychiatric/mental health; quality improvement; safety.

MeSH terms

  • Caregivers
  • Humans
  • Technology
  • Violence* / prevention & control